Abstract

Blood transfusions are governed by the Human Tissue Act. Blood users and providers should be aware of their legal and clinical responsibility when using blood and blood products.

The safety of blood products cannot be guaranteed and an inherent risk remains when using these products. All efforts should be made to optimize safety, and the use of these products should be considered only where valid indications exist. The risk of HIV transmission remains a concern and patients should be aware of these risks. All clinicians and institutions should incorporate good blood use into the standard of practice.
Red blood cell transfusions are indicated to restore oxygen carrying capacity of blood. The importance of perfusion in maintaining oxygenation should not be forgotten and the decision to transfuse should take into consideration not only the haemoglobin level, but also physiological signs of inadequate perfusion.
Preoperative correctable chronic anaemia should be treated pharmacologically. When intra- or postoperative transfusionseems likely clinicians should consider alternatives to allogenic blood transfusion and discuss these options with patients.